Midwives gain valuable insights

Zita Killick, Midwifery Lecturer at Anglia Ruskin University in Chelmsford, Essex, UK, introduces midwifery students to disability issues, helping them to understand the needs of parents with disabilities and special needs.

Anglia Ruskin University works with local NHS trusts to provide midwifery education, with the majority of our students undertaking a three-year degree to become qualified as midwives. Throughout this time there is a mix of theory and placements in all areas where midwives work, in community and hospital settings and at the university.

Specialist education

As a midwifery lecturer, one of the modules I lead is called Special Parents, Special Needs and third year student midwives can take it as an optional module in the last few months of their course when they have had a wide experience of antenatal, labour, postnatal and baby care. Additionally, every student midwife has some introduction to disability issues in their first and second years.

The requirements of parents with disabilities or special needs are many and varied, as is the case for any parent. This module seeks to introduce students to such needs and to explore the most appropriate way to offer support to childbearing women and men and their families, to enable parents to achieve skills, knowledge and confidence to ensure that their childbearing and parenting experiences are positive, rewarding and life-enhancing events.

Lecturers from the mental health and from the learning disabilities teams are invited to lead sessions, and discuss issues raised by students.

The format of the module helps students to self-manage their studying, to reflect on clinical and other experiences and apply theory to practice, working in groups and individually to find out information on a range of relevant issues. By the end of the module (about 15 weeks) students must produce health promotional materials related to the needs of parents they have been assisting in maternity areas and discuss these with the rest of the group as part of the final assessment for this module. Peer group sharing is an invaluable part of the learning process.

Varied topic areas

Some of the areas looked at by students over the last three years include arthritis; cerebral palsy; deafness and hearing impairment; learning difficulties, including dyslexia; multiple sclerosis; physical disability with limited movement of one arm; and blindness and visual impairment.

One student looked at support with breastfeeding for women with learning disabilities. Over the past three years several students have identified the need for improvements in care and services for various clients with a range of learning disabilities.

Another looked at helping a woman with multiple sclerosis, including practical tips for childcare. Several of the same principles proved to be applicable to other parents with mobility problems.

Progressive conditions such as MS and HIV, which were investigated by another student, are cited in the Disability Discrimination Act (DDA) 2005 so that people with these conditions are usually covered by the DDA definition of disability from the time that they first display a symptom associated with the conditions.

Women in prison appear to be a particularly disadvantaged group, sometimes with poor access to pregnancy and parenting education, and this was investigated by another student. She found that mental health problems and lower literacy levels cause further difficulties with obtaining the best services and care, and she identified ways in which services and care could be managed more appropriately.

Other students looked at the needs of deaf women, and discussed potential improvements in support and services.

Sharing good practice

All students are encouraged to share their ideas for improvements with other student midwives, midwives and other health professionals.

Among other issues, the National Service Framework for Children, Young People and Maternity Services requires maternity services to be equitable and accessible to all and complements the purpose of the DDAs of 1995 and 2005. By providing opportunities for our midwifery students to explore issues which they identify from their own contact with disabled parents, students become involved in planning appropriate midwifery care and sharing good practice. Students identify many relevant issues for maternity services, and for other health and social services to consider, and hope to continue their commitment to promote best practice in the area of disability issues throughout their midwifery careers.

We now hope to compile a local database of contacts and help topics about disability and maternity care. We will also be looking with interest at DPPI’s piloting of half-day courses to promote insight into disabled parenting for professionals, organisations and others so we can share our ideas for improvements.

Overall, midwives are developing more knowledge and skills; they are working in partnership with other professionals, voluntary organisations and others, and with parents, who, after all, are the best source for identifying their own needs.

A creative approach

Two students studied the needs of visually impaired women, which stemmed from meeting with blind women at antenatal parenting classes in their maternity units.

One of the modules we took before we qualified as midwives was Special Parents, Special Needs, which gave us an opportunity to research the availability of support services for women with disabilities. The subject we chose was blind and visually impaired parenting. We could not find any resources which suited the needs of the women we met, so we decided to fill the gap ourselves. This included creating teaching aids such as tapes of parenting classes, Braille art of a pelvis and doll, and a leaflet (pictured above) for healthcare professionals caring for these women. One result of our research has led to one of us holding a small caseload of visually impaired women and the other moving into the realm of health visiting to expand and promote the knowledge we have gained.

Julie Williams and Jane Martin

Julie Williams is now a midwife at Basildon and Thurrock University Hospital and Jane Martin is now a midwife at Southend NHS Trust.

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